especially if you have estrogen dominant breast cancer, which accounts for about 70% of all breast cancers diagnosed. This article will explain why, in my opinion, all women with breast cancer should have their estrogen levels tested, and why you should also have a stool test. Let’s get into the nitty-gritty!
Recent Government of Canada stats tells us that 1 in 8 women will be diagnosed with breast cancer in their lifetime. Breast cancer accounts for 26% of ALL NEW cases yearly, which is absolutely staggering. As previously mentioned, estrogen positive cancer is the most common type of cancer that women have.
If you have estrogen positive breast cancer, you will most commonly be prescribed a drug called Tamoxifen, or Letrozole/Anastrozole. These drugs work to lower estrogen in the body so that it cannot continue to stimulate cancer cells and cause them to spread or grow.
However, once you start taking these drugs, how do you know they are working? It is not a standard practice that estrogen levels are tested in the blood, and it is my argument that all women should have their estrogen tested.
A 2009 study recruited women who had been diagnosed with breast cancer and who were also taking an estrogen blocker. Their aim of the study was to actually measure estrogen levels in the blood, so see how much estrogen was lowered. While they found that many women did, in fact, have lowered estrogen levels, they also found that a significant proportion of women did not. In fact, they actually found that some women had higher estrogen levels than they had before starting the drug. They called this rebound estrogen.
Since then, several more recent studies have also confirmed this finding. A 2016 study tested estrogen levels in women taking Tamoxifen and found that 17% of women had estrogen values that were deemed to be above desirable levels (J Clin Oncol, 2016; 34(14)). A 2017 study did the same test in women taking Letrozole, and also found that a significant proportion of women did not have lowered estrogen (Breast Cancer Res Treat, 2017; 161(3)). And again in a study looking at the drug Anastrozole; estrogen levels were not decreasing to what was expected (Steroids, 2015:99).
This is very concerning because this means that the drugs you are taking to prevent cancer from recurring may not actually be working.
Have you heard of the microbiome? This term is all the rage these days. It refers to the entirety of the gut microbes that live in our body, and also all of the genes that these microbes carry. These bacteria and their genes are the subjects of intense focus lately, and researchers are finding that they directly impact our health, and can contribute to heart disease, autoimmune diseases and even cancer.
Let’s go back to estrogen for a second. When our ovaries or other organs produce estrogen, it gets detoxified by the liver, and then a large amount of that detoxified estrogen gets sent to the gut where it ideally leaves our body via our bowel movements. But researchers have shown that there are a number of different types of bacteria that can actually re-activate that estrogen, and that estrogen can then go back into our bloodstream where it has the potential to stimulate breast cancer cells again.
A comprehensive stool analysis can test for the types of bacteria that we know can re-activate estrogen back into our body. This is absolutely critical for a woman with estrogen positive breast cancer, because, for some women, the estrogen-blocking drugs they are taking will not work on this type of re-activated estrogen.
The DUTCH is an incredibly useful test. It is a urine test, that measures the levels of estrogen in our body. We have three types of estrogen, called E1, E2 and E3 (easy, hey?). E1 and E2 are our most biologically active, and they can interconvert. When estrogen is detoxified from the body, it goes through a number of steps. It’s kind of like recycling glass bottles. 1) First, they get sorted. 2) Then they are broken. 3) Those broken pieces then get sorted by size. 4) They get heated. 5) Finally, they are pulverized into very tiny pieces.
Estrogen detoxification has lots of little steps like that. But sometimes, if one step isn’t working properly, it can create a molecule that is capable of damaging DNA, and thus causing cancer. The fancy name for these molecules are called depurinating adducts (in case you want to Google it). It would be like if after the glass bottles are broken, the machine started spitting bits of broken glass all over the factory.
The DUTCH also tests for these detoxification pathways and can see if we are creating any harmful by-products that can cause us harm. Below is a link to a sample DUTCH result report. It looks very busy, but rest assured that the test will be interpreted for you. Pages 1 and 2 have the values of all the different hormones that are tested. On page 3, draw your attention to the middle of the page, where the red arrow leads to a word called “QUINONE” – it is this step that can lead to DNA damage, and that we can see in the DUTCH results.
This test measures 24 different strains of bacteria, many of which are known to be involved in re-activating estrogen in the gut. Additionally, we can see the diversity of our gut bacteria. Studies have shown that the more different types of bacteria we have, the better. This analysis can also test for inflammation and markers of proper digestion.
Testing the microbiome is a very valuable sneak peek into your body, and if you have breast cancer, it could provide you with useful information for other ways to prevent a recurrence. Epidemiological data is suggesting that 16-18% of malignancies might be attributed to our gut microbes. The stool analysis has another cool feature to it, in that it tests all of the microbes for sensitivity to antibiotics and other natural products that have been shown to inhibit the growth of unhealthy organisms.
This means that if we find there is an overgrowth of a possibly harmful strain of bacteria, we can target them and focus on repopulating our gut with a healthier balance of microbes. The link below identifies the different strains of bacteria that are tested, and how they contribute to our health.
If you have estrogen positive breast cancer, it is highly recommended you test your estrogen levels, and see what kind of bacteria you have living in your gut. Estrogen-blocking drugs are an important part of cancer prevention, but it may not be wise to rely entirely on these medications alone. The DUTCH and microbiome testing is the medicine of the future – but you can start utilizing this type of testing today.
Dr. Jessa Landmann is passionate about helping people living with cancer. From reducing the side effects of chemotherapy and radiation to guidance on eating a healthy, preventative diet, she can help at all stages of cancer. She is passionate about helping people living with cancer. From reducing the side effects of chemotherapy and radiation to guidance on eating a healthy, preventative diet, she can help at all stages of cancer.
100% of Dr. Landmann's patients state that a major problem with the health care system is the gap in care once conventional therapy has come to a close. There is very little guidance on how someone can proactively fight the disease and prevent recurrence and even less support with helping them to recover from the intense side effects of chemotherapy and radiation.
Her practice focus is what is called integrative oncology, which is a field of medicine that focuses on the modern practice of medicine while acknowledging the wisdom of traditional healing.
She received the Bachelor of Science from the Univesity of Calgary and the Doctor of Naturopathic Medicine from the Canadian College of Naturopathic Medicine